P2.072: Improved Documentation of Clearance for Sports Participation in Pediatrics

Background: Clearance for sports participation is a crucial component of the adolescent well visit. In the general pediatric practice at University of Maryland, physicians documented if a patient was cleared for sports in the Electronic Medical Record (EMR) using a practice generated dot phrase. Staff could then use this documentation to fill out preparticipation paperwork. However, this documentation was often missing, requiring patients to return for an additional visit leading to increased healthcare burdens for both patients and physicians. The goal of the study was to provide education on the preparticipation evaluation and to optimize the EMR to improve sports clearance documentation.

Methods: A chart review assessing sports clearance documentation was completed for patients ages 12-21 years during a well visit. Baseline documentation was from March-July of 2023. Intervention 1 (March 2024): formal educational sessions on sports clearance documentation. Intervention 2 (May 2024): well visit EMR template updated to include if a child was cleared for sports. Charts were then reviewed March-July 2024 assessing for sports clearance documentation. Documentation compliance rates were compared before and after our interventions using chi-square testing.

Results: We identified 246 charts from 2023 (pre-intervention) and 289 charts from 2024 (post-interventions). The average sports clearance documentation compliance improved from baseline 49% in 2023 to 62% after intervention #1 (p=0.0386) and further improved to 86% after intervention #2 (p < 0.001). [Fig.1] We evaluated compliance for resident and attending physicians and showed similar rates of improvement between the 2 groups. While improved attending compliance was sustained, we did note a drop in resident compliance in July 2024, likely related to new trainees starting that month [Fig. 2].

Conclusion: Failure to document sports clearance during adolescent well visits can lead to additional, unnecessary encounters. Physician education and optimizing EMR templates provided an effective means to improve overall documentation of sports clearance. These results could likely be extrapolated to other important screening tools used during well child visits.